Acute generalized exanthematous pustulosis due to acetazolamide: negative on patch testing and confirmed by delayed-reading intradermal testing

Benamara-Levy, Maeva; Haccard, F.; A, Bera; Machet, L.

doi:10.1111/ced.12214

Cited by 7 publications

(4 citation statements)

References 5 publications

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“…Whether the mechanism of this PNS-induced skin reaction is related to drug-specific T-cells and interleukin-8 needs further investigation. AGEP or pustular drug eruption can be induced by drugs other than antibiotics, including hydroxychloroquine,5,7 sorafenib,8,9 acetazolamide,10 gliclazide,11 recombinant interleukin-2,12 and ibuprofen 13. However, there are no reports in the literature on pustular drug eruption due to traditional Chinese medicine, including PNS.…”

Section: Discussionmentioning

confidence: 99%

Pustular drug eruption due to Panax notoginseng saponins

Yin¹,

Ma²,

Xu³

et al. 2014

DDDT

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Panax notoginseng saponins (PNS) are a patented product in the People’s Republic of China, and have extensive effects on the cardiovascular system. Here we report on four elderly patients (one male and three female) with drug eruption induced by PNS injection. All developed a sudden skin rash with pruritus from head to foot, and subsequently accepted hospitalization. In each case, PNS had been used for less than 1 week before appearance of the rash. No specific short-term medications or changes in diet or exposure to environmental factors immediately prior to appearance of the rash were identified. These four patients had some interesting features in common, ie, pustules, fever, and elevated circulating neutrophil counts, which required high-dose, long-term glucocorticoid therapy. To our knowledge, this is the first report of pustular drug eruption induced by PNS and provides a useful reference and warning for clinicians.

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Section: Discussionmentioning

confidence: 99%

Pustular drug eruption due to Panax notoginseng saponins

Yin¹,

Ma²,

Xu³

et al. 2014

DDDT

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“…The value and safety of skin tests is controversial depending on the clinical entity analyzed [ 26 ]. IDTs with delayed reading have been shown to be useful for determining the responsible drug in patients with AGEP and negative patch tests [ 67 , 104 , 105 ]. They were also helpful in the diagnosis of TEN cases caused by beta-lactam antibiotics [ 106 , 107 ] and in a large series of patients with SJS/TEN [ 108 ].…”

Section: Etiologic Diagnosis: Identification Of the Culprit Drugmentioning

confidence: 99%

Tools for Etiologic Diagnosis of Drug-Induced Allergic Conditions

Rodríguez-Pérez

Vecillas

Cabañas

et al. 2023

IJMS

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Drug hypersensitivity reactions are a serious concern in clinical practice because they can be severe and result in lifelong sequelae. An accurate diagnosis and identification of the culprit drug is essential to prevent future reactions as well as for the identification of safe treatment alternatives. Nonetheless, the diagnosis can be challenging. In vivo and in vitro tests can be helpful, although none are conclusive; therefore, the tests are not usually performed in isolation but as part of a diagnostic algorithm. In addition, some in vitro tests are only available in research laboratories, and standardization has not been fully accomplished. Collaborating research is needed to improve drug hypersensitivity reaction diagnosis. In this review, we update the current available in vivo and in vitro tools with their pros and cons and propose an algorithm to integrate them into clinical practice.

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“…When patch tests are negative, tests with late readings at D2 and D3/D4 may be clearly positive, thus identifying both the causative drug and the delayed-type hypersensitivity mechanism involved. 45,[60][61][62] In fact, intradermal tests are generally more sensitive than patch tests. 7 Intradermal testing with corticosteroids may reveal additional sensitizations not picked up by patch tests, especially in the case of hydrocortisone, which is frequently falsenegative in the patch test.…”

Section: Negative Patch Testsmentioning

confidence: 99%

“…When patch tests are negative, intradermal tests with late readings at D2 and D3/D4 may be clearly positive, thus identifying both the causative drug and the delayed-type hypersensitivity mechanism involved 45,60–62 . In fact, intradermal tests are generally more sensitive than patch tests 7 .…”

Section: Patch Testing In Drug Eruptionsmentioning

confidence: 99%

Patch Testing in Drug Eruptions: Practical Aspects and Literature Review of Eruptions and Culprit Drugs

Groot¹

2022

Dermatitis

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There is overwhelming evidence that many delayed cutaneous adverse drug reactions (beginning >6 hours after drug intake) are mediated by delayed-type (type IV) hypersensitivity, including maculopapular eruptions, erythroderma, symmetrical drug-related intertriginous and flexural exanthema/baboon syndrome, eczematous eruptions, fixed drug eruptions, acute generalized exanthematous pustulosis, and drug reaction with eosinophilia and systemic symptoms/drug-induced hypersensitivity syndrome. Therefore, after resolution of the reaction, patch tests should be performed as first diagnostic method to identify the culprit drug(s). This article provides tools to perform drug patch tests properly and safely, discussing clinical history, indications, procedure, drug patch test materials, sensitivity, the meaning of negative patch tests, and safety of the procedure. In addition, a literature review of eruptions and culprit drugs is provided in tabular format.

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Acute generalized exanthematous pustulosis due to acetazolamide: negative on patch testing and confirmed by delayed-reading intradermal testing

Cited by 7 publications

References 5 publications

Pustular drug eruption due to Panax notoginseng saponins

Pustular drug eruption due to Panax notoginseng saponins

Tools for Etiologic Diagnosis of Drug-Induced Allergic Conditions

Patch Testing in Drug Eruptions: Practical Aspects and Literature Review of Eruptions and Culprit Drugs

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